| NPI | 1083395297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 2599) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 338136) |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2025-06-20 |